“We in public health think about a whole community or population as our patient… When you’re thinking about what happens at the population level, generally you want to be involved in prevention. You don’t want to think about a community or a… particular demographic as already sick and in the hospital. Ideally you’re thinking about… what they’re doing in school, where they are at work, their physical environment, their social environment because those are the things that make us well or sick way before we get to the hospital.”

Dr. Nnorom on thinking about medicine from a public health perspective

1. Profile: Program Director PH/PM (U of Toronto), Black Health Team Lead (Toronto), President (Black Physicians Association of Ontario), Consultant (Nicotine Dependence Clinic at Centre for Addiction and Mental Health); MD (McGill), Master’s Public Health in Epidemiology (Toronto), Community Medicine (now called Public Health and Preventative Medicine) Residency (Toronto)
2. Projects: Black Community Health, Racism as a Social Determinant of Health, Race Health And Happiness Podcast
3. Pitch: Opportunity to enact change on the population/community level in many roles. 
4. Path: Parents inspired an early passion for advocacy in the community. With many passion projects under her belt, Dr. Nnorom discovered Public Health by chance during medical school and zeroed in on the career.
5. Personal: Everybody is susceptible to biases, and it never hurts to take a step back and ask for someone else’s perspective – you will almost certainly learn something new.
6. Philosophy: Every moment is a blessing – let your unique light shine through and try to brighten up the days of those around you.

• Big Picture – Focused on the health of populations, as opposed to individual patients. 
• Opportunities to become medical officers of health, educators, advocates, researchers

• Values prevention, always aware of all the circumstances that led to patients being sick.
• Parents inspired her to be an advocate for communities – how to find solutions to problems outside of the hospital setting

• 5 Canadian Medical Schools had a perception of Public Health as having a primarily administrative workload, with little to no clinical work, making it “not real medicine.”
  • Response: There is more administrative than clinical work, but it remains medicine, albeit a different form. 
  • To be clear, all forms of medicine contain administrative work. The form of administration is different from clinicians – it is literal administration through meetings with politicians, medical officers and public health leaders.
  • There is still the option to work with a family medicine team or emergency medicine physician. Dr. Nnorom feels that her experiences on the ground has greatly informed her ability to practically apply concepts to her policy positions.

Referenced Material: Hau et al. Assessing Canadian medical students’ familiarity with and interest in pursuing a career in community medicine. Can J Public Health 2009;100(3):194-98.

Medical School

• Entered McGill medical school after being involved with a fantastic mentorship program for Black and Racialized Students (Charles Drew Society), which helped her find opportunities to enrich her application and passion for medicine.
• Had a chance, moment meeting with a fellow student who brought up the idea of community medicine. With her past experiences, this became a highly interesting field for Dr. Nnorom.

Residency and early staff experience

• Toronto – 5 year program, 2 years of Family Medicine, 1 year MPH, 2 years of training as a public health physician
  • Rotations in Environmental Health, Chronic Disease, Policy, Communicable Disease, Leadership
• Learned to shift her focus from paternalistic strategy to “fix” communities, to finding acceptable grassroots ways to enact change within them.
  • Any problem the community is facing, the solution is within the community.
• Extended discussion on Community-Based Medicine and the biased lenses we use to examine public health at 16:45

• Starts around 10 am; finish around 5; then start up again after kids go to bed
• Meetings population health, black health
• Giving lectures on racism and health
• 1-day of clinical per week
  • Centre of Addictions and Mental Health – Helping people quit smoking
  • Heavy focus on coaching and psychological support
• Black Physicians Association of Ontario – increasing medical students, establishing the Black Health Education Collaborative series for students and faculty, indigenizing of the medical school curriculum
• A career in public health isn’t for those seeking instant gratification. The satisfaction comes by appreciating long term accomplishments that result from months or years of work. The benefit of this delayed gratification? The changes you help enact can impact thousands of people rather than just one at a time.

Personal Story

“I was a first year resident, and I was on-call for Internal Medicine. When you’re a resident, they will call you to declare a person dead. I had done it a few times, and I went in and I knew that it was a patient who had cancer. But I didn’t know this patient; I hadn’t cared for this patient. It was a young woman with the same birth year as me, 1981. I just remembered seeing that date on the chart, and it shook me to my core. That night it really stuck with me, that we live in a society where people try to say that they’re younger than they are. People don’t want to get older. That experience and some of my experiences in pediatrics just made me think about what a blessing every year and every moment is, and how we often take it for granted… I hope to let my shine brightly and hopefully inspire those who interact with me to dial up their light too, so that we’re all bringing brightness into this world.”

Note: While we tried to keep these transcriptions as true to the speaker as possible, some dialogue is paraphrased and/or edited for easier reading.

1. Everyone has unique talents and gifts that they should share with the world – preventing yourself from doing this leads to emotional and spiritual suffering.
2. There are different paths to public health, you can get there from virtually any residency. If the interest strikes you later in life you can still pivot your career.
3. Most people exist in the space between your Authentic Self and the Performative Self – in between is a playful space, and you should always try to move towards your authentic self.